Featured Research

Common drugs linked to cognitive impairment and possibly to increased risk of death, study suggests

Date:

June 25, 2011

Source:

Indiana University School of Medicine

Summary:

A large, long-term study confirms that medications with anticholinergic activity, which include many drugs frequently taken by older adults, cause cognitive impairment. The research is also the first to identify a possible link between these drugs -- which include over-the-counter and prescription sleep aids and incontinence treatments -- and risk of death.

Share This

A large, long-term study confirms that medications with anticholinergic activity, which include many drugs frequently taken by older adults, cause cognitive impairment. The research is also the first to identify a possible link between these drugs -- which include over-the-counter and prescription sleep aids and incontinence treatments -- and risk of death.

Related Articles

The two-year study of the impact of these medications on 13,000 men and women aged 65 and older is part of the Medical Research Council (UK) Cognitive Function and Ageing Studies (CFAS), a large UK-based longitudinal multi-center study initiative looking at health and cognitive function in older adults. Results of the study of anticholinergics appear June 24, 2011 in an advanced online publication of the Journal of the American Geriatrics Society.

Anticholinergics affect the brain by blocking acetylcholine, a nervous system neurotransmitter. Over-the-counter products containing diphenhydramine, sold under various brand names such as Benadryl®, Dramamine®, Excedrin PM®, Nytol®, Sominex®, Tylenol PM®, and Unisom®, have anticolinergic activity. Other anticholinergic drugs, such as Paxil®, Detrol®, Demerol® and Elavil® are available by prescription.

"Our findings make it clear that clinicians need to review the cumulative anticholinergic burden in people presenting with cognitive impairment to determine if the drugs are causing decline in mental status," said co-author Malaz Boustani, M.D., Regenstrief Institute investigator, Indiana University School of Medicine associate professor of medicine, and research scientist with the IU Center for Aging Research.

"Physicians should review with older patients all the over-the-counter and prescription drugs they are taking to determine exposure," said Dr. Boustani a geriatrician who sees patients at Wishard Health Services' Healthy Aging Brain Center in Indianapolis.

The researchers, led by Chris Fox, M.D., of the University of East Anglia and Carol Brayne, M.D. of the University of Cambridge, used the Anticholinergic Cognitive Burden Scale developed by Dr. Boustani and colleagues at the Regenstrief Institute, Indiana University and in the United Kingdom to evaluate the link between anticholinergic activity and cognitive decline.

Medications with anticholinergic effects are used for many diseases including hypertension and congestive heart failure. The study found that older age, lower income, and greater number of health conditions increased use of medications with anticholinergic activity. Women were more likely to report taking anticholinergic medications, due to the greater number of health conditions reported by women than by men. Participants living in institutions were more likely to report taking anticholinergic medications.

"We looked at drugs with either moderate and severe anticholinergic activity. After adjusting for age, sex, baseline mental status, education, income level, number of non-anticholinergic medications and health conditions, we found that taking anticholinergic medications was linked to cognitive impairment and for the first time to death," said study corresponding author Dr. Fox, a psychiatrist. "We need follow-up to determine the degree to which anticholinergics are being prescribed for diseases with significant risk of death and the impact of that on our findings."

Authors of the study are Chris Fox, M.D., University of East Anglia; Carol Brayne, M.D., Kathryn Richardson, M.Sc. and George M. Savva, Ph.D, University of Cambridge; Ian D. Maidment, M.A., Kent and Medway NHS and Social Care Partnership Trust; Fiona E. Matthews, Ph.D., Medical Research Council Biostatistics Unit; David Smithard, M.D., Kent Community Health NHS Trust; Simon Coulton M.Sc., University of Kent; Cornelius Katona, M.D., University College London and Malaz Boustani, M.D., M.P.H., Regenstrief Institute, Indiana University School of Medicine and IU Center for Aging Research.

"The Anticholinergic Medication Use and Cognitive Impairment in the Older Population: The Medical Research Council Cognitive Function and Ageing Study (CFAS)" was funded by the Medical Research Council.

"The Medical Research Council invests in cohort studies like CFAS because they provide vital clinical information through observation. Such projects require long-term commitment to fulfill their potential but having supported cohort studies for well over half a century, MRC funding and collaborations have made us an international leader in this field," said Chris Kennard, MBBS, Ph.D., chairman of the MRC's Neuroscience and Mental Health Board.

Dr. Boustani's development of the Anticholinergic Burden Scale was supported by the U.S. National Institute on Aging.

Indiana University School of Medicine. "Common drugs linked to cognitive impairment and possibly to increased risk of death, study suggests." ScienceDaily. ScienceDaily, 25 June 2011. <www.sciencedaily.com/releases/2011/06/110624111929.htm>.

Indiana University School of Medicine. (2011, June 25). Common drugs linked to cognitive impairment and possibly to increased risk of death, study suggests. ScienceDaily. Retrieved March 3, 2015 from www.sciencedaily.com/releases/2011/06/110624111929.htm

Indiana University School of Medicine. "Common drugs linked to cognitive impairment and possibly to increased risk of death, study suggests." ScienceDaily. www.sciencedaily.com/releases/2011/06/110624111929.htm (accessed March 3, 2015).

More From ScienceDaily

More Mind & Brain News

Featured Research

Mar. 3, 2015 — The literary great Marcel Proust wore ear-stoppers because he was unable to filter out irrelevant noise -- and lined his bedroom with cork to attenuate sound. Now new research suggests why the ... full story

Mar. 3, 2015 — Attendance at schools exposed to high levels of traffic-related air pollution is linked to slower cognitive development among 7- to 10-year-old children in Barcelona, according to a new ... full story

Mar. 3, 2015 — No significant change in home habits of smokers have been observed in the aftermath of a ban on smoking in public spaces, researchers report. Greater inspiration to kick the habit likely comes from ... full story

Mar. 3, 2015 — Heart function has been associated with the development of dementia and Alzheimer's disease through a new study. Participants with decreased heart function, measured by cardiac index, were two to ... full story

Mar. 3, 2015 — Children of recently separated or divorced families are likelier to drink sugar-sweetened beverages than children in families where the parents are married, putting them at higher risk for obesity ... full story

Mar. 3, 2015 — Although sedatives are often administered before surgery, a randomized trial finds that among patients undergoing elective surgery under general anesthesia, receiving the sedative lorazepam before ... full story

Mar. 3, 2015 — Why do people shake hands? A new study suggests one of the reasons for this ancient custom may be to check out each other's odors. Even if we are not consciously aware of this, handshaking may ... full story

Mar. 3, 2015 — It appears that stress markers in unemployed people can be found, independent of smoking, alcohol consumption and overweight/obesity. Results from a study suggest that long-term unemployment may be ... full story

Mar. 3, 2015 — On the heels of an American nationwide measles outbreak comes a report that campaigns aimed at scaring people about the consequences of non-vaccination might not be as effective as many think. ... full story

Mar. 3, 2015 — Doctors write millions of prescriptions a year for drugs to calm the behavior of people with Alzheimer’s disease and other types of dementia. But non-drug approaches actually work better, and carry ... full story

Related Stories

Jan. 26, 2015 — A new study probes the possibility of reversing the adverse cognitive effects of medications frequently prescribed to older adults for chronic conditions including depression, anxiety and ... full story

Aug. 25, 2014 — People with cognitive impairment are significantly more likely to have a stroke, with a 39 percent increased risk, than people with normal cognitive function, according to a new study. Cognitive ... full story

May 7, 2013 — Research on medications commonly taken by older adults has found that drugs with strong anticholinergic effects cause cognitive impairment when taken continuously for as few as 60 days. A similar ... full story

July 13, 2010 — Drugs commonly taken for a variety of common medical conditions including insomnia, allergies, or incontinence negatively affect the brain causing long term cognitive impairment in older ... full story

ScienceDaily features breaking news and videos about the latest discoveries in health, technology, the environment, and more -- from major news services and leading universities, scientific journals, and research organizations.